Assessing Mitral Valve Prolapse Severity Through Echocardiography Findings

Doppler and Echocardiography

M-Mode Doppler IVSd 9.37 mm MV E Vel 94.25 cm/s LVIDd 51.44 mm MV DecT 152.08 ms LVPWd 9.46 mm MV Dec Slope 6.20 m/s LVIDs 32.07 mm MV A Vel 54.86 cm/s EDV (Teich) 126.31 ml MV E/A Ratio 1.72 ESV (Teich) 41.18 ml MV PHT 44.10 ms EF (Teich) 67.39% MVA By PHT 4.99 cm² %FS 37.65% AV Vmax 113.62 cm/s SV (Teich) 85.12 ml AV maxPG 5.16 mmHg SI (Teich) 43.43 ml/m² PA Vmax 1.55 m/s RWT 0.37 PA maxPG 9.66 mmHg Ao Diam 28.21 mm LA Diam 38.87 mm TR Vmax 178.25 cm/s LA/Ao 1.38 TR maxPG 12.71 mmHg RVIDd 9.46 mm A’ (LW) 7.11 cm/s RVIDs 8.92 mm A’ (SP) 14.72 cm/s EPSS 0.89 cm E’ (LW) 14.13 cm/s IVC 1.24 cm E’ (SP) 14.02 cm/s E’ (AVG) 14.08 cm/s E’/A’ (LW) 1.99 E’/A’ (SP) 0.95 E/E’ (LW) 6.67 E/E’ (SP) 6.72 E/E’ (AVG) 6.69 DAVC 337.8 ms Peak SL Dispersion Full 41.1 ms G peak SL Full (APLAX) -20.1% G peak SL Full (A4C) -21.6% G peak SL Full (A2C) -25.5% G peak SL Full (Avg) -22.4% BA PSSL Full -18.6% BI PSSL Full -19.7% MA PSSL Full -22.8% MI PSSL Full -23.8% AA PSSL Full -36.4% AI PSSL Full -36.1% BAS PSSL Full -16.6% BP PSSL Full -18.5% MAS PSSL Full -16.5% MP PSSL Full Print? Date: 08/08/2022 -20.3% AAS PSSL Full -14.2% AP PSSL Full -32.3% BS PSSL Full -16.3% MA PSSL Full -22.8% MP PSSL Full -20.3% BL PSSL Full -14.0% MS PSSL Full -20.7% ML PSSL Full -18.5% AS PSSL Full -32.4% AL PSSL Full -29.5% HR_4Ch_Q 69.1 bpm LVVED_4Ch_Q 108.8 ml LVVES_4Ch_Q 42.1 ml LVEF_4Ch_Q 61.4% LVSV_4Ch_Q 66.8 ml LVCO_4Ch_Q 4.6 l/min LVLs_4Ch_Q 5.6 cm LVLd_4Ch_Q 7.5 cm HR_2Ch_Q 69.1 bpm LVVED_2Ch_Q 79.6 ml LVVES_2Ch_Q 26.6 ml LVEF_2Ch_Q 66.6% LVSV_2Ch_Q 53.0 ml LVCO_2Ch_Q 3.7 l/min LVLs_2Ch_Q 5.3 cm LVLd_2Ch_Q 7.0 cm LVVED_BiP_Q 93.0 ml LVVES_BiP_Q 33.4 ml LVEF_BiP_Q 64.1% LVSV_BiP_Q 59.6 ml LVCO_BiP_Q 4.1 l/min Findings Summary 1.
Borderline left ventricular hypertrophy (LVH) and left atrial enlargement (LAE), with preserved left ventricular systolic function, LVEF 60-65%.
2.
Mitral valve prolapse (MVP) - anterior mitral leaflet (AML), with mild mitral regurgitation (MR).
3.
Mild tricuspid regurgitation (TR), right ventricular systolic pressure (RVSP) 22 mmHg.
4.
No inferior vena cava (IVC) engorgement.

Can the doctor determine the severity of the mitral valve prolapse from this? Because a diagnosis of mitral valve prolapse has been made and a previous echocardiogram report was uploaded for the doctor to review, which indicated normal cardiac function.
Since I have seen this report, I would like to inquire again.
Thank you.

Xiang, 30~39 year old female. Ask Date: 2022/12/22

Dr. He Dongjin reply Cardiology

Hello, regarding the report, the mitral valve prolapse is not severe, only mild.
Please do not worry.
Changhua Hospital cares about you.

Reply Date: 2022/12/22

More Info

Mitral Valve Prolapse (MVP) is a condition where the mitral valve does not close properly, which can lead to mitral regurgitation (MR). The severity of MVP can be assessed through echocardiography, which provides valuable insights into the structure and function of the heart, particularly the mitral valve and surrounding chambers.

In your echocardiography report, several key measurements and findings are noted that can help in assessing the severity of MVP:
1. Mitral Valve Functionality: The report indicates that there is mild MR associated with MVP. This suggests that while the valve is not functioning perfectly, the degree of regurgitation is not severe. Mild MR typically does not cause significant symptoms or require immediate intervention. However, it is essential to monitor it over time to ensure it does not progress.

2. Left Atrial Size: The left atrial (LA) diameter is reported as 38.87 mm. An enlarged left atrium can be a consequence of chronic MR, as the atrium may dilate to accommodate the increased volume of blood that regurgitates back into it. In your case, the LA size is within a borderline range, indicating that while there is some enlargement, it is not excessively large, which is a positive sign.

3. Left Ventricular Function: The left ventricular ejection fraction (LVEF) is reported at 67.39%, which is within the normal range (typically above 55% is considered normal). This indicates that the left ventricle is pumping effectively, and there is no significant impairment in systolic function, which is crucial in assessing the overall impact of MVP on heart function.

4. Doppler Measurements: The Doppler findings, including the E/A ratio of 1.72, suggest that the diastolic function of the left ventricle is preserved. This is important because impaired diastolic function can lead to heart failure symptoms, but your report indicates that this is not currently an issue.

5. Pulmonary Artery Pressure: The reported RVSP (right ventricular systolic pressure) of 22 mmHg is within normal limits (typically under 25 mmHg is considered normal). This suggests that there is no significant pulmonary hypertension, which can sometimes accompany severe MR.

6. Overall Assessment: The summary of findings indicates borderline left ventricular hypertrophy (LVH) and left atrial enlargement (LAE), but with preserved left ventricular systolic function. This means that while there are some changes in the heart's structure, the heart is still functioning adequately.

In conclusion, your echocardiography findings suggest that you have mild MVP with mild MR, and while there are some structural changes in the heart, the overall function remains preserved. Regular follow-up with echocardiography is advisable to monitor any changes in the mitral valve function or the size of the heart chambers. If symptoms such as palpitations, chest pain, or shortness of breath develop, further evaluation may be warranted. Always consult with your cardiologist for personalized advice and management based on your specific situation.

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